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Rich Construction, Inc. A2015-151 isi 1.4.1 CITY OF CHINO HILLS AGREEMENT FOR CONSTRUCTION OF LOS SERRANOS INFRASTRUCTURE IMPROVEMENTS PHASE 2B PROJECT NO. D12008 This Agreement is made and entered into on the 9th day of June, 2015 by and between the City of Chino Hills, a California General Law Municipal Corporation ("City") and RICH CONSTRUCTION, INC. ("Contractor"). City and Contractor do hereby agree as follows: The complete contract includes all of the Contract Documents, to wit: A. Notice Inviting Bids, Dated April 28, 2015 B. Instructions to Bidders C. Addenda D. Contractor's Bid (Bid Documents), Dated May 28, 2015 E. Bid Bond F. Payment Bond G. Contract Performance Bond H. Certificates of Insurance and Endorsements I. Agreement J. Certified Copy of the record of action of the City Council of City of Chino Hills, Chino Hills, California. K. Notice of Award L. Notice to Proceed M. The Plans (Contract Drawings) N. Document entitled, "Notice to Bidders. Proposal. Contract. and Soecial Provisions", including appendices. O. Standard Specifications for Public Works Construction. P. Standard Plans Q. Reference documents R. Change Orders or Work Change Directives S. Public Improvement Warranty Each of such documents in their entirety are incorporated herein by this reference as if set forth in full. II. The Contractor agrees to perform certain work set forth and particularly described in the aforementioned documents, incorporated herein by reference in consideration of: TOTAL BASE BID: $334,500.00 1-1 III. Contractor shall furnish a labor and material bond in an amount equal to one hundred percent (100%) of the contract price, and a faithful performance bond in an amount equal to one hundred percent (100%) of the contract price, said bonds to be secured from a surety company admitted and authorized to do business in California as such and satisfactory to the City Council. Upon filing of the Notice of Completion, Contractor shall be required to maintain a labor and material bond for a period of six (6) months and shall furnish a warranty bond in the amount of 15% of the contract amount for a period of twelve (12) months. IV. The Contractor agrees to indemnify, protect, defend and hold harmless the City, and their authorized agents, officers, volunteers, the engineer and employees against any and all claims arising from Contractor's acts or omissions and for any costs or expenses incurred by the City, or their authorized agents, officers, volunteers and employees, on account of any claim therefore. In order to accomplish the indemnification herein provided for, but without limiting the indemnification, the Contractor shall secure and maintain throughout the term of the contract the following types of insurance with limits as shown: - Workers' Compensation -A program of Workers' Compensation Insurance or a State-approved Self Insurance Program in an amount and form to meet all applicable requirements of the Labor Code of the State of California, including Employer's Liability with One Million Dollars ($1,000,000.00) limits, covering all persons providing services on behalf of the Contractor and all risks to such persons under this Agreement. - General Liability - Such aeneral liability insurance shall be written with a limit of liability of not less than One Million Dollars ($1.000.000.00) combined single limits for damages arising out of bodily iniurv, including sickness and death, injury to or destruction of property of others, arising directly or indirectly out of or in connection with the performance of the Work under the Contract Documents including explosion, collapse and underground exposure. - Vehicle Liability - Such vehicle liability insurance shall be written with a limit of liability of not less than One Million Dollars ($1.000.000.00) combined single limits for all bodily injury, including sickness and death or injury to or destruction of property of others, arising directly or indirectly out of or in connection with the performance of the Work under the Contract Documents including explosion, collapse and underground exposure. If the City determines to require the Contractor to procure such insurance, such insurance shall cover as insureds under all policies excepting workers compensation the City, its officers, employees, and agents, City's 1-2 Representative, the Engineer and his/her consultants, and each of their officers, employees, and agents. The policy or policies for such insurance may provide for a deductible amount not to exceed five percent (5%) of the Contract Price. As provided in Section 7105 of the California Public Contract Code, the Contractor is responsible for the cost of repairing or restoring work up to five (5%) percent of the contract amount. All insurance required herein shall be placed with insurers with a current A.M. Best's rating of no less than A:VII, and which insurers are admitted and authorized to do business in California as insurance carriers. Contractor shall, within ten (10) calendar days after receipt of the notice of award from the City, furnish certificates of insurance and endorsements to the City evidencing the insurance coverage above required prior to the commencement of performance of services hereunder, which certificates shall provide that such insurance shall not be terminated or expire without thirty (30) days written notice to the City, and shall maintain such insurance from the time Contractor commences performances of services hereunder until the completion of such services All policies, with respect to the insurance coverage above required, except for the Workers' Compensation Insurance coverage and professional liability coverage, if applicable, shall obtain additional endorsements covering the City and its employees, agents, volunteers and officers as insureds with respect to liabilities arising out of the performance of services hereunder. The Contractor shall require the carriers of the above required coverages to waive all rights of subrogation against the City, its officers, volunteers, employees, contractors, agents and subcontractors. All policies required above are to be primary and non-contributing with any insurance or self-insurance programs carried or administered by the City. V. The City agrees to pay, and the Contractor agrees to accept in full payment for the work outlined in the Contract Documents, the sum of Three Hundred Thirty-Four Thousand, Five Hundred and XX/100 dollars ($334,500.00) subject to additions and deductions, if any, in accordance with said documents. Payment shall not be made more often than once each thirty (30) days, nor shall amount paid be in excess of ninety-five percent (95%) of the contract at time of completion. Final payment to be made forty-five (45) days subsequent to acceptance of the work by the City Council. Contractor may, upon Contractor's written request, and approved by the City Council, at Contractor's expense, deposit substitute securities, as stated in Government Code Section 16430, and as authorized by Public Contract Code, Section 22300, in lieu of retention monies withheld to insure performance. 1-3 VI. The Contractor shall commence the work required by this Contract within ten (10) days of the date specified in the Notice to Proceed from the City to proceed with the work and shall complete bid items within forty-five (45) working days. City and Contractor have discussed the provisions of Government Code, Section 53069.85 and the damages that may be incurred by City if the Work is not completed within the time specified in this Agreement. The City and Contractor hereby represent that at the time of signing this Agreement, it is impracticable and extremely difficult to fix the actual damage which will be incurred by City if the Work is not completed within the number of working days allowed. Accordingly, City and Contractor agree that the sum of one thousand dollars($1.000.00 ) per calendar day is a reasonable sum to assess as damages to City by reason of the failure of Contractor to complete the Work within the time specified. The Contractor shall start construction operation on or before July it. 2015. Failure to start work on July 15th. 2015. will subject the Contractor to a penalty of $5.000 per day for each additional day of delay of operation. VII. The Contractor hereby agrees to comply with the State Labor Code and acknowledges that, in accordance with Section 3700 of the State Labor Code, he/she will be required to secure the payment of compensation to his/her employees. VIII. The Contractor acknowledges that, in accordance with Section 1777.5 of the State Labor Code, he/she will be held responsible for compliance with the provisions of this Section for all apprenticeable occupations. IX. The Contractor hereby agrees to reimburse the City for costs incurred by the awarding authority in the substitution of subcontractors. Where a hearing held pursuant to the provisions of Chapter 2, Division 5, Title 1, of the Government Code (commencing with Section 4100) by the awarding authority or a duly appointed hearing officer, the Clerk of the City of Chino Hills shall prepare and certify a statement of all costs incurred by the City for investigation and conduct of the hearing, including the costs of any hearing officer and shorthand reporter appointed. The statement shall then be sent to the general contractor, who shall reimburse the City for such costs. If not paid separately, such reimbursement may be deducted from any money due and owning to the general contractor prior to acceptance of the project. 1-4 X. Contractor acknowledges and agrees that Contractor must have all appropriate contractor's licenses. Contractor further warrants and represents that he/she/they has/have the appropriate contractor's license to pursue the work hereunder. Contractor's failure to have or maintain all appropriate licenses during the entire term of this contract, or any period thereof, shall be cause for the immediate and summary termination of this contract by City. Contractor shall be liable for all City's costs to complete the work and this contract. Xl. The person or persons executing this Agreement on behalf of contractor warrants and represents he/she/they has/have the authority to execute this Agreement on behalf of his/her/their corporation, partnership, or business entity and warrant and represents that he/she/they has/have the authority to bind contractor to the performance of its obligations hereunder. XII. NOTICES: Notices shall be given pursuant to this Agreement by personnel services on the party to be notified, or by written notice upon such party deposited in the custody of the United States Postal Service addressed as follows: City: City of Chino Hills Attn: City Clerk 14000 City Center Drive Chino Hills, CA 91709-4868 Contractor: Rich Construction, Inc. Attn: Rich Sieverding, President 24480 Jenny Lane Murrieta, CA 92562-9417 XIII. This Agreement contains the completely final, entire, and exclusive agreement between the parties with respect to the subject matter hereof, and no waiver, alteration, or modification of any of the provisions hereof or rights to act hereunder shall be binding unless in writing. Any attempted modification, amendment, or alteration in violation hereof shall be void. 1-5 IN WITNESS WHEREOF, each of the parties hereto has caused the Agreement to be executed in its name on its behalf by a duly authorized officer as of this day and year first above written. CITY OF CHINO HILLS RICH CONSTRUCTION, INC. WB : iVl �twr/ FAC= 0, � By: C...=::2: 14a-' .4et). Cynthi0 Moran, Mayor Signatufe of Chairman of Board, President, or Vice President Attest: c+1wic.Q St Ek/E2.0 sa)G Iris I (Typed/Printed Name) ice'/ 4' By: • • i^ES r ocwT Cheryl Balz (Title) City Clerk B Signatui'e of Secretary, Assistant/ Approved as to Form: Secretary, CFO, or Assistant Treasurer • S B = I , . �_ c , e vE.z..0Sv v Mark)D:Hensley (Typed/Printed Name) City AttorneyCSEC 1./erna_-r- (/ (Title) 1-6 4147 ° I 5‘02% Pl\o-vvt -k CR 7eD5 S6 &o 5 � � n mac-- 1 .2oos, k‘e ( s 2 ° CI tzi's-J0 RECEIVED 2045 MAY 28 PM 92: 57eQ �¢ c8vi©�iiLLs firrarnott) .!" cf/2 Corkez-, /2106 t C 1 e3 BID DOCUMENTS The following listed documents, identified in the lower right corner as "Bid Document", bound herein and reproduced on colored paper, shall be fully executed and submitted with the Bid prior to the time of the opening of Bids. 1.3.1 Bid (Proposal) 1.3.2 Bid Schedule(s) 1.3.3 List of Subcontractors 1.3.4 Anti-Trust Claim 1.3.5 Non-collusion Affidavit 1.3.6 Bid Bond (Bid Security Form) 1.3.7 Bidder's General Information Failure of a Bidder to fully execute and submit all of the listed documents with the Bid will render a Bid as non-responsive and subject to rejection. CITY OF CHINO HILLS - PART I 1-10 1.3.1 B I D (PROPOSAL) BID TO: CITY OF CHINO HILLS, CALIFORNIA The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an Agreement with the City in the form included in the Contract Documents to perform the Work as specified or indicated in said Contract Documents entitled: LOS SERRANOS INFRASTRUCTURE IMPROVEMENTS PHASE 2B PROJECT NO. D12008 Bidder accepts all of the terms and conditions of the Contract Documents, including without limitation those in the Notice Inviting Bids and the Instructions to Bidders dealing with the disposition of the Bid Security. This Bid will remain open for the period stated in the Notice Inviting Bids, unless otherwise required by law. Bidder will enter into an Agreement within the time-and in the manner required in the Instructions to Bidders, and will furnish the insurance certificates, Payment Bond, Performance Bond, and all Permits required by the Contract Documents. Bidder has examined copies of all the Contract Documents, including the following Addenda (receipt of which is hereby acknowledged): Number 1 X Date -sot b J/c- Number 2 Y Date SAL ./S Number 3 Date Number 4 Date Number 5 Date Number 6 Date Bidder has familiarized itself with the nature and extent of the Contract Documents, the Work, the site, the locality where the Work is to be performed, the legal requirements (federal, state, and local laws, ordinances, rules, and regulations), and the conditions affecting cost, progress, or performance of the Work, and has made such independent investigations as Bidder deems necessary. CITY OF CHINO HILLS - PART I 1-11 1.3.1 B I D (PROPOSAL) continued In conformance with the current statutory requirements of California Labor Code Section 1860, et seq., the undersigned confirms the following as its certification: I am aware of the provisions of Section 3700 of the Labor Code, which require every employer to be insured against liability for worker's compensation, or to undertake self-insurance in accordance with the provisions, before commencing the performance of the Work of this Contract. To all the foregoing, and including all Bid Schedule(s), List of Subcontractors, Non- collusion Affidavit, Bidder's General Information, and Bid Bond contained in these Bid Documents, said Bidder further agrees to complete the Work required under the Contract Documents within the Contract Time stipulated in said Contract Documents, and to accept in full payment therefor the Contract Price based on the Lump Sum or Unit Bid Price(s) named in the aforementioned Bidding Schedule(s). Dated: 51oZ (..e I I S Bidder:RIOE CWSr ruCrIOn Inc . gy , ., (Sign4ture) ', V Title: —PreStbEI ST- CITY OF CHINO HILLS - PART I 1-12 1.3.2 UNIT PRICE BID SCHEDULE Schedule of Prices for the Construction of the: LOS SERRANOS INFRASTRUCTURE IMPROVEMENTS PHASE 2B PROJECT NO. D12008 Item Description Est. Qty. Unit Unit Price Amount No. 1. Mobilization 1 LS $ $ ez' X0,0/lgo/>• > 2. Provide Traffic Control 1 LS $ 95v. - $ , 7o 3 Sheeting, Shoring, and Bracing, 1 LS $ Z,2620. $ (oU or Equivalent Method 4. Clear and Grubbing 1 LS - $ x,359? /3, 597 Furnish and install 18-in RCP �7 5' per plans and City Std. 118 87 LF $ �j $ 395, 6 Furnish and install 36-in RCP 806 LF $ /97, $45--4 per plans and City Std. 118 ��� — Construct Local Depression 7. Sump per City STD 202 and 2 EA $/ X00 $ a ado Detail as shown hereon Construct Catch Basin per City 8' STD 205, W=7', V=2.95' 2 EA $ /1 �a0 $ 9 02. 0. Construct 36-inch CMP Riser 9. with trash rack per Detail A of 2 EA $� o9u - $ 0/?O — plans. Construct concrete collar per 10. City Std. SD103 1 EA $ /00 $ 4700, Construct Water/Sewer Main 11. Encasement per City STD W- 4 EA $ ,/� $ / '7,{0. 20/S-13 Construct Storm Drain 12. Manhole per SSPWC Stds 3 EA $ , $ 320-2 �/�, Relocate Ex. 4-inch Blow-Off 7/ 13. 1 per City STD W-29 EA $7/ ' $ / ` CITY OF CHINO HILLS - PART I 1-13 UNIT PRICE BID SCHEDULE (cont) Schedule of Prices for the Construction of the: LOS SERRANOS INFRASTRUCTURE IMPROVEMENTS PHASE 2B PROJECT NO. D12008 14. Relocate 1-inch Domestic 1 LS $ $ Water Service line. �� 5/€f Construct P.C.C. Energy 15. Dissipater/Outlet structure with 1 LS $ $ vertical Baffle Walls per 29 Opo_ a 0 po . SSPWC STD 384-3, W=10' 16. Plug End of 36 inch RCP with 1 EA $ 070. - $ gam Brick and mortar flange Fill, Re-grade & Compact the its 17. area per plan and per City 1 LS $4�$S2t. $ Engineer instructions 18. Remove and Replace 6-ft. high 30 LF $ $ — chain link fence o2b. (FDo. Construct Graded Trapezoidal Channel with P.C.C. gunite 19. surface, Ditch Bottom 1 LS $ S '�Atirdth=3', Too Width andDao 02/) DDD Deptil varies Install 12-inch thick grouted 20. stone rip-rap 8-inch nominal 240 SF // p va (o fD diameterI Restoration of pavement , z, ,, „ i striping and markers I icj0� �, 96�• Total of All items (1-21) of the Bid Schedule: 3Si0° (Price in figures) Mee- ALICeecti ern, xst �,> ��leti /4Per invyurds)__,Z& /CYC 64t c4 /ate tCt �\ /onnsr icC,TIon jr., Name of Bidder CITY OF CHINO HILLS-PART I 1-14 1.3.3 LIST OF SUBCONTRACTORS INFORMATION REQUIRED OF BIDDER As required under Section 4100, et seq., of the Public Contract Code, the Bidder shall list below the name and business address of each subcontractor who will perform Work under this Bid in excess of one-half of one percent of the Contractor's Total Bid Price, and shall also list the portion of the Work which will be done by such subcontractor. After the opening of Bids, no changes or substitutions will be allowed except as otherwise provided by law. The listing of more than one subcontractor for each item of Work to be performed with the words "and/or" will not be permitted. The Contractor shall perform, with its own organization, Contract work amounting to at least 50 percent of the Contract Price except that any designated "Specialty Items" may be performed by subcontract. The amount of any such "Specialty Items" so performed may be deducted from the Contract Price before computing the amount required to be performed by the Contractor with its own organization. The City will identify any "Specialty Items" in the Bid or Proposal. Where an entire item is subcontracted, the value of work subcontracted will be based on the Contract Unit Price. When a portion of an item is subcontracted, the value of work subcontracted will be based on the estimated percentage of the Contract unit price. This will be determined from information submitted by the Contractor and subject to approval by the Engineer. `5, 9 /e),,_4?—.) /S' T 1. Work to be Performed: 6'�uzere � ai/i.S % of Total Contract: /'42 Subcontractor's Name: P nu Cobv0 Cc 4y t) Ch CW --I-t3 C • Address: 6 /Sq /11 sem- Lentr `a ,,/75a W6E/.0.6€ e FSE d License No. 6/4 71' to 15—S 4, Is the Subcontractor registered in accordance with Labor Code § 1725.5 [Note: failure to register requires the City to reject Contractor's bid as nonresponsive)? Yes a No El 2. Work to be Performed: /}eOia-►4-t-7— I % of Total Contract: c(.5,7oSubcontractor's Name: Pi+rime, `S ) .0 SI G Address: 560 Al o +4 to st 02►wGE (2t4 9e s- / CITY OF CHINO HILLS- PART I 1-15 1.3.3 LIST OF SUBCONTRACTORS INFORMATION REQUIRED/ OF BIDDER (cont') 0� License No. 7 ,a57 Is the Subcontractor registered in accordance with Labor Code § 1725.5 [Note: failure to register requires the City to reject Contractor's bid as nonresponsive]? Yes A No 0 3. Work to be Performed: rrerv\ / q % of Total Contract: 8 7,, Subcontractor's Name: Psi. 5 c° //f 'TY C_4-& Address: ',./6 3 kc-T J/n AtiE c -S 5 r & .. Ot 910&so - c18°3 License No. 906—q17, Is the Subcontractor registered in accordance with Labor Code § 1725.5 [Note: failure to register requires the City to reject Contractor's bid as nonresponsive)? Yes No 0 4. Work to be Performed: % of Total Contract: Subcontractor's Name: Address: License No. Is the Subcontractor registered in accordance with Labor Code § 1725.5 [Note: failure to register requires the City to reject Contractor's bid as nonresponsive)? Yes 0 No 0 CITY OF CHINO HILLS - PART I 1-16 1.3.3 LIST OF SUBCONTRACTORS INFORMATION REQUIRED OF BIDDER (cont') 5. Work to be Performed: % of Total Contract: Subcontractor's Name: Address: License No. Is the Subcontractor registered in accordance with Labor Code § 1725.5 [Note: failure to register requires the City to reject Contractor's bid as nonresponsive]? Yes 0 No 0 6. Work to be Performed: % of Total Contract: Subcontractor's Name: Address: License No. Is the Subcontractor registered in accordance with Labor Code § 1725.5 [Note: failure to register requires the City to reject Contractor's bid as nonresponsive]? Yes 0 No 0 CITY OF CHINO HILLS - PART I 1-17 1.3.4 ANTI-TRUST CLAIM In submitting a Bid to a public purchasing body, the Bidder offers and agrees that if the Bid is accepted, it will assign to the purchasing body all rights, title and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C. Section 15) or under the Cartwright Act (Chapter 2 of Part 2 of Division 7 of the Business and Professions Code) arising from purchases of goods, materials, or services by the Bidder for sale to the purchasing body pursuant to the Bid. Such assignment shall be made and become effective at the time the purchasing body tenders final payment to the Bidder. RESPECTFULLY SUBMITTED: dir Sig�iature / Address -t V)(I iaaient _ l .6q. 921ea C45) Leo " 1S&Z' City, State, Zip s Telephone (with area code) ?g,,ES/b r 5/2.6) 1 r5 Title Date` 457® ®// Contractor's License No. Type of License 31- Ooit9042-0 Federal I.D. No. (SEAL--if Bid is by a corporation) ATTES '4 . icAc CITY OF CHINO HILLS - PART I 1-18 1.3.5 NON-COLLUSION AFFIDAVIT (Public Contract Code Section 7106) In accordance with Public Contract Code 7106, the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Non-collusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Non- collusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. CITY OF CHINO HILLS - PART I 1-19 • 12.6 BID BOND KNOW ALL MEN BY THESE PRESENTS, that we, the undersigned, Rich Construction. Inc. as Principal, and Indemnity Company of California as Surety are hereby held and firmlybound unto the Qv of Chino Hills. a California General Law Municipal Corporation, as'Owner.in the penal sum of --ten percent (10%) of the total amount bid by the-Prindipal— for the-payment of • which, well and truly to be made, we hereby jointly and severally bind ourselves, successors and assigns. Signed, this 19th day of May ,2015 . .The Condition of the above obligation is such that whereas the Principal has submitted to the City of Chino Hills a certain Bid, attached hereto and hereby made a part hereof to enter into a contract in writing for the Los Serranos Infrastructure Improvements NOW, THEREFORE, a, If said Bid shall be rejected, or b. If said Bid shall be accepted and the Principal shall execute and deliver, within ten (10) days after acceptance. a contract in the form attached hereto (properly completed in accordance with said Bid) and shall furnish a Bond for his/her faithful performance of said Contract and for the payment of all persons performing labor or furnishing materials in connection therewith, the required Insurance-Certificates, and shall in all other respects perform the agreement created by the acceptance of said Bid, then this obligation shall be void, otherwise the same shallremainin force and effect; it being expressly understood and agreed that the liability of the Surety for any and all claims hereunder shall, in no event, exceed the penal amount of this obligation as herein stated. The Surety, for value received, hereby stipulates and agrees that the obligation of said Surety and its Bond shall be in no way impaired or affected by ally extension of the time within which the City may accept such Bid; and said Surety does hereby waive notice of any such extension. In the event suit is brought upon this bond by the Obligee and judgment is recovered, the Surety shall pay all costs incurred by the Obligee in such suit, including a reasonable attomey's fee to be fixed by the court. CITY OF CHINO HILLS- PART I 1-20 1.3.6 BID BOND (page 2 of 3) IN WITNESS WHEREOF, the Principal and the Surety have hereunto set their hands and seals, and such of them as are corporations have caused their corporate seals to be hereto affixed and these presents to be signed by their proper officers, the day and year first set forth above. Two Witnesses PRINCIPAL: Rich Construction, Inc. (If Individual): �(///�o • By Lt e c fez Title Ke--e.,0 /2,e.41 tt6 Al I EST (IfIfCorporation): By TtbC.X t___ H/1 etti�� Title\(I, i� c rC4 (Corporate Seal) SURETY: Indemnity Company of California ATTEST: By 41,>t_U >, v` B, fi`` i •‘ 11a4, Title Shannon Looez: 1.3.6 BID BOND (page.3 of 3) Any claims under this bond may be addressed to: (Name and Address of Surety) Indemnity Company of California PO Box 19725 Irvine, CA 92623 (Name and Address of Agent (same as above) or Representative in California if different from above) (Telephone Number of Surety 800.223.2451 and Agent.or Representative in California) CITY OF CHINO HILLS- PART I 1-22 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT State of California County of San Bernardino On May 19. 2015 before me S. Lynn Ewer. Notary Public. personally appeared Shannon Lopez who proved to me on the basis of satisfactory evidence to be the person(s)whose names) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signatures) on the instrument the person(s), or the entity upon behalf of which the persons) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. s, LYNN EWER '( Commission # 1983601 z ler �. E�a Notary Public - California San Bernardino County �'— My Comm.Expires Jul 26,20166 Signature �.Com, �� (Seal) .vim POWER OF ATTORNEY FOR DEVELOPERS SURETY AND INDEMNITY COMPANY INDEMNITY COMPANY OF CALIFORNIA PO Box 19725,IRVINE,CA 92623 (949)263-3300 KNOW ALL BY THESE PRESENTS that except as expressly limited,DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA,do each hereby make,constitute and appoint: ***George A. DeCristo, Shannon Lopez, Peter M. Davis, Martin M. Davis, Faith M. LaValle, Elizabeth D. Kolpien, Gail E. Connor, jointly or severally*** as their true and lawful Attorney(s)-in-Fact,to make,execute,deliver and acknowledge,for and on behalf of said corporations,as sureties,bonds,undertakings and contracts of suretyship giving and granting unto said Attorney(s)-in-Fact full power and authority to do and to perform every act necessary,requisite or proper to be done in connection therewith as each of said corporations could do,but reserving to each of said corporations full power of substitution and revocation,and all of the acts of said Attorney(s)-in-Fact,pursuant to these presents,are hereby ratified and confirmed. This Power of Attorney is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respective Boards of Directors of DEVELOPERS SURETY ' AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA,effective as of January 1st,2008. RESOLVED,that a combination of any two of the Chairman of the Board,the President,Executive Vice-President,Senior Vice-President or any Vice President of the corporations be,and that each of them hereby is,authorized to execute this Power of Attorney,qualifying the attorney(s)named in the Power of Attorney to execute,on behalf of the corporations,bonds,undertakings and contracts of suretyship;and that the Secretary or any Assistant Secretary of either of the corporations be,and each of them hereby is,authorized to attest the execution of any such Power of Attorney; RESOLVED,FURTHER,that the signatures of such officers may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures shall be valid and binding upon the corporations when so affixed and in the future with respect to any bond,undertaking or contract of suretyship to which it is attached. IN WITNESS WHEREOF,DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severally caused these presents to be signed by their respective officers and attested by their respective Secretary or Assistant Secretary this January 29,2015. By: "'JI'L^�[�c/9 J` Y POR Iv ' `GOMC.tPORO C Daniel Young,Senior Vice-President / Vir ,.y raV00 4"4"' .y? �� VO , TH 9r, :lett OCT.10E`•ei- = Z OCT.OCT5 ''T By .-wi ` o�>; 1936 ,r 0 1967 2 Mark Lansdon,Vice-President ''' \o.,(owe,./?. 2 c"9<lFOP�\P i. A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of Orange On January 29.2015 )efore me, Lucille Raymond.Notary Public Date Here insert Name and Tale of the Officer personally appeared Daniel Youno and Mark Lansdon Name(s)of&grerte) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s)is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies),and that by his/her/their signature(s)on the instrument the person(s),or the entity upon behalf of LUCILLE RAYMOND A A which the person(s)acted,executed the instrument. Commission 0 2001965 :pile/ill Notary Public-California li I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is ^I'! Orange County = true and correct .da `" My' Comm.Expires Oct 9• " ' s - . ., . , . . - < ., .. . v� WITNESS my hand and official seal. Place Notary Seal Above Signature Lucillk wirond,Notary Public 1 CERTIFICATE �+ The undersigned,as Secretary or Assistant Secretary of DEVELOPERS SURETY AND INDEMNITY COMPANY or INDEMNITY COMPANY OF CALIFORNIA,does hereby certify that the foregoing Power of Attorney remains in full force and has not been revoked and,furthermore,that the provisions of the resolutions of the respective Boards of Directors of said corporations set forth in the Power of Attorney are in force as of the date of this Certificate. This Certificatee is executed in the City of Ir ine,California,this brre ig day of M 0 ' ZOIC By: ( P• `7!e' L Cassie J jPrrisford,Assistant Se rgetary ID-1380(Rev.01/15) (/ CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 :KL,„ezr ortgCk gekr nravaawaa '. n• 4...-.. ;, ,,,-, '., n. ,.. . ..'... ":RLsF. kw,,,ettr .GS'.x;Rh>.4 `C,ws,i A notary public or other officer completing this certificate verifies only the identity of the Individual who signed the document to which this certificate is attached,and not the truthfulness, accuracy, or validity of that document. State of California ) County oil; (tf-P ItS\CLD ) On Tl L�-i� R7 .'1-016 before me <h -%'cil aillil UU'. •, .004e,1tA 0~x-40 — -tiDateCC Here Insert Name and Title oS=t)re Officer personally appeared F >I(U O h (-)0 CA 2 Jtv ott no, C NaGne f'of Signer,(sf who proved to me on the basis of satisfactory evidence to be the person(rwhose nam is subs ibed to the within instrument and acknowled ed to me that-he s�Jekf+ey executed the same in ti- en r-' uthorized capacity(ies),and that by their signature(s)-on the Instrument the person($ or t e entity upon behalf of which the persop(s)acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. ,� , � w SARAH BROCKMAN� WITNESS m and and official seal. vCommission M2008031 I Notary Public-California F IS-11.• Riverside County Signature a n n I C 111 Y�i^ v_ _+ M Comm.holies Feb 17,2011 Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: I)) (-1. t?p,ckdtL Document Date: Number of Pages: Signer(s) Other Than Named Above: Capaci (ies) Claimed by Signer(s) Signer's \.me: Sig r's Name: ❑Corporat- officer — Title(s): ❑Co .orate Officer — Title(s): ❑ Partner — '1 ited ❑General ❑Partne ❑ Limited ❑ General ❑ Individual • , orney in Fact ❑Individual ❑Attorney in Fact ❑Trustee ❑Gua n or Conservator ❑Trustee Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: ,7„, 'E7>UM<;., .r-r. '.r.Yv 44'L:. .. -a%.e4-4 exon- W..�Z' ...w.wvwWw..n:..:xww..w..a a GaGF 02014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item #5907 1.3.6 BID BOND cSet i� 6( KNOW ALL MEN BY THESE PRESENTS, that we, the undersigned, as Principal, and as Surety are hereby held and firmly bound unto the City of Chino Hills, a California General Law Municipal Corporation, as Owner in the penal sum of for the payment of which, well and truly to be made, we hereby jointly and severally bind ourselves, successors and assigns. Signed, this day of , 20 . The Condition of the above obligation is such that whereas the Principal has submitted to the a certain Bid, attached hereto and hereby made a part hereof to enter into a contract in writing for the NOW, THEREFORE, a. If said Bid shall be rejected, or b. If said Bid shall be accepted and the Principal shall execute and deliver, within ten (10) days after acceptance, a contract in the form attached hereto (properly completed in accordance with said Bid) and shall furnish a Bond for his/her faithful performance of said Contract and for the payment of all persons performing labor or furnishing materials in connection therewith, the required Insurance Certificates, and shall in all other respects perform the agreement created by the acceptance of said Bid, then this obligation shall be void, otherwise the same shall remain in force and effect; it being expressly understood and agreed that the liability of the Surety for any and all claims hereunder shall, in no event, exceed the penal amount of this obligation as herein stated. The Surety, for value received, hereby stipulates and agrees that the obligation of said Surety and its Bond shall be in no way impaired or affected by any extension of the time within which the City may accept such Bid; and said Surety does hereby waive notice of any such extension. In the event suit is brought upon this bond by the Obligee and judgment is recovered, the Surety shall pay all costs incurred by the Obligee in such suit, including a reasonable attorney's fee to be fixed by the court. CITY OF CHINO HILLS - PART I 1-20 t3.6 BID BOND (page 2 of 3) IN WITNESS WHEREOF, the Principal and the Surety have hereunto set their hands and seals, and such of them as are corporations have caused their corporate seals to be hereto affixed and these presents to be signed by their proper officers, the day and year first set forth above. Two Witnesses PRINCIPAL: (If Individual): By Title ATTEST (If Corporation): By Title (Corporate Seal) SURETY: ATTEST: By By Title Title (Corporate Seal) IMPORTANT: Surety companies executing Bonds must possess a certificate of authority from the California Insurance Commissioner authorizing them to write surety insurance defined in Section 105 of the California Insurance Code, and if the work or project is financed, in whole or in part, with federal grant or loan funds, must also appear on the Treasury Department's most current list (Circular 570 as amended). THIS IS A REQUIRED FORM. CITY OF CHINO HILLS - PART I 1-21 1.3.6 BID BOND (page 3 of 3) Any claims under this bond may be addressed to: (Name and Address of Surety) (Name and Address of Agent or Representative in California if different from above) (Telephone Number of Surety and Agent or Representative in California) CITY OF CHINO HILLS - PART I 1-22 1.3.7 BIDDER'S GENERAL INFORMATION The Bidder shall furnish the following information. Failure to complete all Items will cause the Bid to be non-responsive and may cause its rejection. 1. BIDDER/CONTRACTOR'S Name and Street Address: TICS anStLLQ.,-cton Tnc 48o .\EffU LW M i.teneiic . (' vA"), 4325149;2_, — 2. 2 ,2-- 2. CONTRACTOR'S Telephone Number: (q51) IJOD-. 01'7 a- Facsimile Number: (6151) 1.01)() - '15 $ a- 3. CONTRACTOR'S License: Primary Classification A State License Number(s) 454;10 1 Supplemental License Classifications 4. Is the Bidder/Contractor registered in accordance with Labor Code § 1725.5 [Note: failure to register requires the City to reject Contractor's bid as nonresponsive]? Yes No 0 5. Surety Company and Agent who will provide the required Bonds on this Contract: Name of Surety:// Nee (90gry cC o P 7 " Address: 1e / /y.u6 Wt-e- /ewes . n 9-1J573 ( Surety Company Agent: Ecu2[, &-& J2 r;��o Telephone Numbers: Agent (95) ) c.35'a-igeD Surety ((0? ) _79a 6. Type of Firm (Individual, Partnership or Corporation): / s L'c7iela CITY OF CHINO HILLS - PART I 1-23 1.3.7 BIDDER'S GENERAL INFORMATION (Continued) 7. Corporation organized under the laws of the State of: dli.. 8. List the names and addresses of the principal members of the firm or names and titles of the principal officers of the corporat'on or firm: Petal L. L9Evc(eac /nj,tt ,ci,-`i /sec 9. No. of years experience as contractor in this specific type construction work: a i S - 10. List at least three related projects comyleted to date: a. Owner `5G,YI+n ana \Co ( (en Address '79 /0 (1 .t -ate te Q.Gv Contact a ' CL a cf<_nolch.vnn Phone 76o a/ a- O(o 95 Project S49107/ 4174 5% t _ Class of Work Snie. n ,5iEG/i7 _ Cul kir/ Scat,— Contract Scams. Contract Amount o2,D0, 000 . Date Completed b. Owner Address Contact Phone Project Class of Work Contract Amount Date Completed CITY OF CHINO HILLS - PART I 1-24 Rich Construction Ince Issaiikaalli MurMieta,Ca.92562 Phone:760 445-3143 Fax:760 645-7117 E-Mail:rlsieverding@yahoo.com Corporate Resume License #456011 Reference Projects San Bernardino Water District $ gdf City of San Bernardino,Michael Nevarez 909 384-5092 300 North D Street,San Bernardino,Ca.92418 Vine Street Water Line Santa Ana College Brucon, Bruce Stenderson 760 212-0695 7910 Camino Del Rey,Bonsall,Ca. Storm Drain, Water,and Sewer. La Mesa Segment 426.4 M11)8 San Diego Trolley Bud Jess 213 369-1867 9 Sewer,Water,Storm Drain,Pump Station. Sanderson Lift Station Eastern Municipal Water District 951 928-2060 2270 Trumble Rd, Perris,Ca.92570 Fig Street Sewer City Of Escondido Public Works 760 839-4668 475 N.Spruce St. Escondido,Ca.92025 Sewer Main Zone 3 &4 Pump Station City of Newport Beach 949 644-3309 100 Civic Center Dr.Newport Beach,Ca. Moosa Canyon Pump Station Valley Center Water District 760 735-4500 29300 Valley Center rd, Valley Center,Ca. Page 2 AT & SF Railroad Switching Yard City of Oceanside,Ca. Orlando King, Pountney&Associates 619 576-9200 Grading and Underground Peacock Meadows,Sub- Division Oceanside, Ca. Ramos Jensen Co. Pam Young Underground 10th Avenue Marine Terminal Unified Port District,San Diego,Ca. Wayne Clover, Port District 619 291-3900 Quail Ridge MEB Development Corp. San Juan Capistrano,Ca. Michael Brown,MEl3 Development 619 722-4700 Underground Rising Glen Multi Tech Properties San Diego,Ca. Gary Scholz,Quest Construction 619 587-9897 Underground Williams Ranch Community Facilities District#1 City of Oceanside George Kermott, Inspector,City of Oceanside Underground,Grading,Streets. 1.3.7 BIDDER'S GENERAL INFORMATION (Continued) c. Owner Address . __ Contact - - Phone Project Class of Work F ' t.; Contract Amount Date Completed 11. List the name and title of the person who will supervise full-time the proposed work for your firm: J 12. Is full-time supervisor an employee VAS OR contract services ? 13. A financial statement or other information and references sufficiently comprehensive to permit an appraisal of your current financial condition may be required by the Engineer. CITY OF CHINO HILLS- PART I 1-25 t36.8 Federal Requirements CITY OF CHINO HILLS - PART I 1-26 1.3.8 FEDERAL REQUIREMENTS 1, In submitting the Bid, the Bidder offers and agrees that if the Bid is accepted, notwithstanding any state or local laws and regulations, all Federal laws and regulations shall be adhered to. In case of conflict between Federal, state, or local laws or regulations, the strictest shall be adhered to. 2. In submitting the bid, the bidder is aware that this is a public works project requiring payments of prevailing wage rates, Certified Payrolls are required to be submitted weekly by the Contractor, subcontractor(s), and owner operator. Contract payments will be withheld for delinquent or inadequate Certified Payrolls (LC 1771.5). 3. In submitting the Bid, the Bidder offers and agrees that if the Bid is accepted, the Bidder and the subcontractor(s) shall perform all work in accordance with the project Plans and Specifications, including all stipulations designed to meet diversified Federal Environmental, Architectural and related laws and regulations. 4. In submitting the Bid, the Bidder offers and agrees that if the bid is accepted, the Bidder and the subcontractor(s) shall allow the comptroller general of the United States, all authorized Federal, state, county, and/or City officials access to the work area, fiscal, payroll, materials, and other relevant Contract records. All relevant records shall be retained for at least three years. 5. The Contractor and the subcontractor(s) shall comply with the Lead Based Paint Poisoning Prevention Act and the Implementation Regulations (24 CFR 35) issued pursuant thereto, and any amendments thereof. 6. The Contractor and the subcontractor(s) shall comply with Section 503 of the Rehabilitation Act of 1973 (P.L. 93-112), and the Implementation Regulations (41 CFR 60-741) issued pursuant thereto and any amendments thereof. 7. The Contractor and the subcontractors) shall comply with Section 402, Vietnam Era Veterans Adjustment Assistance Act of 1974, and the implementation Regulations (41 CFR 30- 250) issued pursuant thereto. 8. The Contractor and the subcontractor(s) shall comply with Title IV of the Civil Rights Act of 1964. and Title VIII of the Civil Rights Act of 1968, and any amendments thereof. 9. The Contractor and the subcontractor(s) shall comply with ail applicable standards, orders, or requirements issued under section 306 of the Clean Air Act (42 U.S.0 1857h), section 508 of the Clean Water Act (33 U.S.C. 1368), Executive Order 11738, Environmental Protection Agency regulations (40 CFR Part 15), the Federal Water Pollution Act (P.L. 92-500) as amended, and all applicable standards or regulations (40 CFR Part 15 and 61) issued pursuant to the said acts. 10. The Contractor and the subcontractor(s) shall comply with the Davis-Bacon Fair Labor Standards Act (40 USC 276 a to a-7), and the implementation regulations issued pursuant thereto (29 CFR Section 1, 5), any amendments thereof and the California Labor Code. Pursuant to the said regulations, entitled "Federal Labor Standards Provisions," "Federal Prevailing Wage Decision," and "State of California Prevailing Wage Rates" respectively. The Contractor shall post the "Federal Prevailing Wage Decision" and "State of California Prevailing Wage Rates." 1-28 (1) 11. The Contractor and the subcontractor(s) shall comply with the Copeland Anti-Kickback. Act (18 USC 874), and the Implementation Regulations (29 CFR 3) issued out-suet-it thereto, Rod any srnan:'.rnente thereof. 12. The Contractor and the subcontractor(s) shall comply with the Contract work hours, the Safety S.t-c!derds a t (40 USC 327-332), and the Implementation Reaulatinns l20 CFR 5) issued nurcliant thereto. and arty amendments thereof 13. The Contractor shall display the Project Sign, post the "Notice to all Employees Working or Federal or Federally Financed Construction Projects," and the "Equal Employment Opportunity is.. THE T_p,, ..." posters, federal and state wage rates, and other re uimed matedecil. in a visible lcceiiion Far the job site. The signs and posters shall be mounted in an acceptable manner end erisitifirod (ass coy`sindi ifor pititsteiis). 14. The Contractor shall comply with all laws, ordinances, and regulations applicable to the work. If the Contractor ascertains at any time that any of the requirements of the Contract are at variance with applicable law, ordinances, regulations, or building code requirements, he or she shall promptly notify the City of Chino Hills, Engineering Department, and shall not proceed with the work in question, except at his or her own risk, until the Engineer has had an opportunity to determine the extent of the responsibility for the variance and the appropriate corrective actions to be undertaken. 15. Wherever applicable, the Contractor and the subcontractor(s) shall comply with Federal Management Circular No„ 74-4, and the Office of Management and Budget Circular No. 102, and any amendments thereof. 16. The Contractor and the subcontractor(s) shall comply with the Executive Order 11246 and the Implementation Regulations (24 CFR 130 and 41 CFR Chapter 60) issued pursuant to the regulations. The Contractor and the subcontractor(s) agree to complete, execute, and submit the "Equal Employment Opportunity Certification" (HUD-92010) with the Agreement if awarded the Bid. 17. The Contractor and the subcontractor(s) shall comply with Section 3 of the Housing and Community Development Act of 1968 and the regulations (24 CFR 135) issued pursuant thereto, and amendments thereof. 18. The Contractor and the subcontractor(s) shall comply with the Affirmative Action reporting requirements, entitled "Combined Work Force Profile." 19. Wherever applicable, the Contractor and the subcontractor(s) shall comply with Section 109 of the Housing and Community Development Act of 1974, and the Implementation Regulations (24 CFR 570.601) issued pursuant thereto, and any amendments thereof, 20. Federal Employee Benefit Clause: "No member of, or delegate to, the Congress of the United States, and no Resident Commissioner shall be admitted to any share or part of the Agreement to the said project or to any benefit to arise from the same." 21. The undersigned as Bidder swears under penalty of perjury that no more than one final, unappealable finding of contempt of court, by a federal court, has been issued against the Bidder (Contractor) within the immediately preceding two-year period because of the Bidder's (Contractor's) failure to comply with an order of a federal court, which orders the Contractor to comply with an order of the National Labor Relations Board. A finding of contempt does not include any finding which has been vacated, dismissed, or otherwise removed by the court because the Bidder (Contractor) has complied with the order which was the basis for the finding (PCC 10232). 1-28 (2) 22.The list of subcontractors, material suppliers and questionnaire regarding Bidder, are considered part of the Federal Contracting Requirements, and are included in the Bid Proposal. They are required to be completed by the Bidder. 23. The Bidder shall submit the "Non - Collusion Affidavit" with the Bid (PCC 7106). 24. The proposed Contractor and the subcontractor(s) shall complete the "Race and Ethnic Data Reporting Form, HUD-27061," and submit with the agreement. 25, The proposed Contractor and the subcontractor(s) shall complete and execute the "Certification Regarding Debarment and Suspension, (Title 49, Code of Federal Regulations, Part 29) HUD-2992 and submit with the Bid. 26. The Contractor shall complete and execute the "Certification of Nonsegregated Facilities," and submit it with the Bid. 27. The Bidder shall complete, execute, and submit the "Disclosure of Lobbying Activities, Form LLL,"with the Bid. 28. Along with the Bid, the Contractor shall submit the "Contractors Certification on Federal Contract Requirements" to certify complete understanding of the diversified Federal requirements imposed on the Contractor(s) of HUD-funded construction projects. 29. The Bidder i LR l on-nn Snake:✓On Inc. /� —" (Contractors Name) is a l Loft)©rel t on (individual, partnership, or corporation) CA If a corporation, Incorporated under the laws of the State of �► ` If an individual, state individual's name. If a partnership, state names of all individuals, co-partners, composing the firm. If a corporation, state names of president, secretary, treasurer and chief executive officer thereof. gest ‘c.nard S reveird i nG V i CIL PCt st ben t- - l$v l lam, Steve-ra 30. Questionnaire Reaardina Bidder Because this project is federally funded, it is necessary to obtain information concerning type of ownership participation for statistical purposes, for the U.S. Department of Housing and Urban Development (HUD). (a) [] Female (b) Male Number of years engaged in the contracting business under present business name 3 1 . 1-28 (3) 31. In submitting this Bid, the undersigned as Bidder agrees to perform, with its own organization, work amounting to at least fifty percent (50%) of the bid amount except that any designated "specialty items" may be performed by subcontract and may be deducted from the bid amount before computing the amount of work required to be performed by the Bidder. If the Bidder, after computing the amount of work required, fails to meet at least fifty percent (50%) of the amount of work required with its own forces, the Bid will be considered non-responsive and will be rejected with no further consideration. 32. The Bidder understands that if he or she fails to specify a subcontractor or if a bidder specifies more than one subcontractor for the same portion of work to be performed under the contract in excess of one half of one percent (0.5%) of the bidder's total bid, the bidder shall be deemed to have agreed to perform such portion himself or herself, and that he or she shall not be permitted to sublet or subcontract that portion of the work except as may be duly consented to by the City pursuant to the provisions of Section 4107, of the Public Contract Code (PCC 4106). 33. The Bidder understands that circumvention by a general contractor who bids as a prime contractor of the requirement under Section 4104 for him or her to list his or her subcontractors, by the device of listing another contractor who will in turn sublet portions constituting the majority of the work covered by the prime contract, shall be considered a violation of Chapter 4 "Subletting and Subcontracting" starting with Section 4100 of the Public Contract Code and shall subject that prime contractor to the penalties set forth in Section 4110 and 4111 of the Public Contract Code (PCC 4105). 34. In compliance with the provisions of the Public Contract Code, Section 4104, the undersigned Bidder herewith sets forth the name and location of the place of business of each subcontractor who will perform work or labor or render service to the prime Contractor in or about the construction of the work or improvement, or a subcontractor licensed by the State of California who, under subcontract to the prime Contractor, specially fabricates and installs a portion of the work or improvement according to detailed drawings contained in the Plans and Specifications, in an amount in excess of one-half of one percent (0.5%) of the prime Contractor's total bid, or in the case of Bids for the construction of streets, highways, including bridges, in excess of one-half of one percent (0.5%) of the prime Contractor's total bid or ten thousand dollars ($10,000), whichever is greater, and the portion of the work which will be done by each subcontractor. The Bidder shall not list more than one subcontractor for the same portion of work. All additional information required by the City regarding any subcontractor who the Bidder is required to list under the Provisions of Sections 4104 and 4107 of the Public Contract Code, other than the subcontractor's name and location of business, may be submitted by the Bidder up to 24 hours after the deadline time and date for receipt of Bids. Failure to timely provide all required subcontractor information shall result in the Bid being determined nonresponsive. 1-28 (4) REQUIRED CONTRACTOR/ SUBCONTRACTORS' INFORMATION -1NAME OF CONTRACTOR LICENSE NO,AND CLASSIFICATION' ; TELEPHONE OWNERSHIP(CIRCLE ONE): SECTION 3 BUSINESS/RESIDENT, NOT APPLICABLE 0 ADDRESS BID AMOUNT % OF ITEM TOTAL NOS_ BID LCITY,ZIP , , . . NAME OF SUBCONTRACTOR LICENSE ND,AND CLASSIFICATION TELEPHONE OWNERSHIP(CIRCLE ONE): SECTION 3 BUSINESS/RESIDENT, NOT APPLICABLE ADDRESS BID AMOUNT % OF ITEM TOTAL 1 NOS. BID 1 CITY,ZIP ji i NAME OF SUBCONTRACTOR LICENSE NO.AND CLASSIFICATION TELEPHONE OWNERSHIP(CIRCLE ONE): SECTION 3 BUSINESS/RESIDENT, NOT APPLICABLE ADDRESS BID AMOUNT %OF ITEM TOTAL NOS. BID CIT Y,ZIP I I1 J_- --i 1-28 (5) REQUIRED SUBCONTRACTORS' INFORMATION NAME OF SUBCONTRACTOR LICENSE NO,AND CLASSIFICATION 1 TELEPHONE OWNERSHIP(CIRCLE ONE): SECTION 3 BUSINESS/RESIDENT, NOT APPLICABLE ADDRESS BID AMOUNT %OF '1 ITEM TOTAL ' NOS. BID ! CITY,ZIP I I „ NAME OF SUBCONTRACTOR LICENSE NO.AND CLASSIFICATIO -1N TELEPHONE OWNERSHIP(CIRCLE ONE); SECTION 3 BUSINESS/RESIDENT, NOT APPLICABLE I ADDRESS BID AMOUNT %OF ITEM TOTAL NOS. BID CITY, ZIP 1 NAME OF SUBCONTRACTOR LICENSE NO.AND CLASSIFICATION TELEPHONE OWNERSHIP(CIRCLE ONE): SECTION 3 BUSINESS/RESIDENT, NOT APPLICABLE I ADDRESS BID AMOUNT % OF ITEM TOTAL NOS. BID 1 CITY,ZIP 1 II .---.I.,--- I . 1-28 (6) This project is federally funded, and the Bidder is requested to state if the supplier is a Section 3 Business or Resident. LIST OF MATERIAL SUPPLIERS NAME MATERIAL(S)SUPPLIED II ADDRESS OWNERSHIP(CIRCLE ONE) SECTION 3 BUSINESS SECTION 3 RESIDENT NOT APPLICABLE CITY,ZIP TELEPHONE I NAME MATERIAL(S)SUPPLIED ADDRESS OWNERSHIP(CIRCLE ONE) SECTION 3 BUSINESS SECTION 3 RESIDENT NOT APPLICABLE CITY,ZIP TELEPHONE NAME MATERIAL(S)SUPPLIED Il ' ADDRESS OWNERSHIP(CIRCLE ONE) SECTION 3 BUSINESS SECTION 3 RESIDENT NOT APPLICABLE CITY,ZIP TELEPHONE IIL NAME MATERIAL(S)SUPPLIED ADDRESS OWNERSHIP(CIRCLE ONE) SECTION 3 BUSINESS SECTION 3 RESIDENT I NOT APPLICABLE CITY,ZIP TELEPHONE I 1-28 (7) Certification Regarding U.S. Department of Housing Debarment and Suspension and Urban Development Certification A: Certification Regarding Debarment, Suspension,and Other Responsibility Platters—Primary 4. The prospective primary participant shall provide Covered Transactions immediate written notice to the department or agency to whom this proposal is submitted if at any time the 1. The prospective primary participant certifies to the best prospective primary participant learns that its certification of its knowledge and belief that its principals; was erroneous when submitted or has become erroneous by • a. Are not presently debarred, suspended, proposed reason of changed circumstances. for debarment, declared ineligible, or voluntarily excluded 5. The terms covered transaction, debarred, from covered transactions by any Federal debarment or suspended, ineligible, lower tier covered transaction, agency; participant, person, primary covered transaction, b. Have not within a three-year period preceding this principal, proposal, and voluntarily excluded, as used in proposal, been convicted of or had a civil judgment this clause,have the meanings set out in the Definitions and rendered against them for commission of fraud or a criminal Coverage sections of the rules implementing Executive offense in connection with obtaining, attempting to obtain, Order 12549. You may contact the department or agency to or performing a public(Federal, State, or local)transaction which this proposal is being submitted for assistance in or contract under a public transaction; violation of Federal obtaining a copy of these regulations. or State antitrust statutes or commission of embezzlement, 6. The prospective primary participant agrees by theft, forgery, bribery, falsification, or destruction of submitting this proposal that, should the proposed covered records, making false statements, or receiving stolen transaction be entered into, it shall not knowingly enter into property; any lower tier covered transaction with a person who is c. Are not presently indicted for or otherwise debarred, suspended, declared ineligible, or voluntarily criminally or civilly charged by a governmental entity excluded from participation in this covered transaction, (Federal, State, or local) with commission of any of the unless authorized by the department or agency entering into offenses enumerated in paragraph(I)(b)of this certification; this transaction. and 7. The prospective primary participant further agrees by d. Have not within a three-year period preceding this submitting this proposal that it will include the clause titled application/proposal had one or more public transactions "Certification Regarding Debarment, Suspension, (Federal State,or local)terminated for cause or default. Ineligibility and Voluntary Exclusion—Lower Tier Covered Transaction,"provided by the department or agency entering 2. Where the prospective primary participant is unable to into this covered transaction, without modification, in all certify to any of the statement in this certification, such lower tier covered transactions and in all solicitations for prospective participant shall attach an explanation to this lower tier covered transactions. proposal. 8. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier Instructions for Certification(A) covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered 1. By signing and submitting this proposal, the transaction, unless it knows that the certification is prospective primary participant is providing the certification erroneous. A participant may decide the method and set out below. frequency by which it determines this eligibility of its 2. The inability of a person to provide the certification principals. Each participant may, but is not required to, required below will not necessarily result in denial of check the Nonprocurement List. participation in this covered transaction. The prospective 9. Nothing contained in the foregoing shall be construed participant shall submit an explanation of why it cannot to require establishment of a system of records in order to provide the certification set out below, The certification or render in good faith the certification required by this clause. explanation will be considered in connection with the The knowledge and information of a participant is not department or agency's determination whether to enter into required to exceed that which is normally possessed by a this transaction. However, failure of the prospective prudent person in the ordinary course of business dealings. primary participant to famish a certification or an 10. Except for transactions authorized under paragraph(6) explanation shall disqualify such person from participation of these instructions,if a participant in a covered transaction in this transaction. knowingly enters into a lower tier covered transaction with a 3. The certification in this clause is a material person who is suspended,debarred,ineligible, or voluntarily representation of fact upon which reliance was placed when excluded from participation in this transaction,in addition to the department or agency determined to enter into this other remedies available to the Federal Government, the transaction. If it is later determined that the prospective department or agency may terminate this transaction for primary participant knowingly rendered an erroneous cause certification, in addition to other remedies available to the of default. Federal Government, the department or agency may terminate this transaction for cause of default. 1-28 (8) Form HUD-2992(3/98) Certification B:Certification Regarding Debarment,Suspension, Ineligibility and Voluntary Exclusion — Lower Tier Covered Transactions 1. The prospective lower tier participant certifies, by 5. The prospective lower tier participant agrees by submitting submission of this proposal, that neither it nor its principals is this proposal that, should the proposed covered transaction be presently debarred, suspended, proposed for debarment, declared entered into, it shall not knowingly enter into any lower tier ineligible, or voluntarily excluded from participation in this covered transaction with a person which is debarred, suspended, transaction by any Federal department or agency. declared ineligible, or voluntarily excluded from participation in 2. Where the prospective lower tier participant is unable to this covered transaction, unless authorized by the department or certify to any of the statements in this certification, such agency with which this transaction originated. prospective participant shall attach an explanation to this 6. The prospective lower tier participant further agrees by proposal. submitting this proposal that it will include this clause titled "Certification Regarding Debarment,Suspension,Ineligibility and Instructions for Certification (B) Voluntary Exclusion--Lower Tier Covered Transaction,"without modification, in all lower tier covered transactions and in all 1. By signing and submitting this proposal, the prospective solicitations for lower tier covered transactions. lower tier participant is providing the certification set out below. 7. A participant in a covered transaction may rely upon a 2. The certification in this clause is a material representation of certification of a prospective participant in a lower tier covered fact upon which reliance was placed when this transaction was transaction that it is not debarred, suspended, ineligible, or entered into. If it is later determined that the prospective lower voluntarily excluded from the covered transaction,unless it knows tier participant knowingly rendered an erroneous certification, in that the certification is erroneous. A participant may decide the addition to other remedies available to the Federal Government, method and frequency by which it determines the eligibility of its the department or agency with which this transaction originated principals. Each participant may,but is not required to exceed that may pursue available remedies, including suspension and/or which is normally possessed by a prudent person in the ordinary debarment, course of business dealings. 3. The prospective lower tier participant shall provide 8. Nothing contained in the foregoing shall be construed to immediate written notice to the person to which this proposal is require establishment of a system of records in order to render in submitted if at any time the prospective lower tier participant good faith the certification required by this clause. The learns that its certification was erroneous when submitted or has knowledge and information of a participant is not required to become erroneous by reason of changed circumstances. exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph (5) of these instruction, if a participant in a lower covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction,in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies including suspension and/or debarment. kVA Applicant J Date Signature of Authorized Certifying Official Title Form HUD-2992(3/98) 1-28 (9) CERTIFICATION of NONSEGREGATED FACILITIES (FEDERALLY ASSISTED PROJECTSI PROJECT NO. D13005 LOS SERRANOS INFRASTRUCTURE — STORM DRAIN IMPROVEMENTS ON COUNTRY CLUB DRIVE The federally assisted construction Contractor certifies that he or she does not maintain or provide for his or her employees any segregated facilities at any of his or her establishments, and that he or she does not permit his or her employees to perform their services at any location under his or her control where segregated facilities are maintained. The federally assisted construction Contractor certifies further that he or she will not maintain or provide for his or her employees any segregated facilities at any of his or her establishments, and that he or she will not permit his or her employees to perform their services at any location under his or her control where segregated facilities are maintained. The federally assisted construction Contractor agrees that a breach of this certification is a violation of the Equal Opportunity clause in this Contract. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, rest rooms and washrooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, creed, color, or national origin, because of habit, local custom or otherwise. The federally assisted construction Contractor agrees that (except where he or she has obtained identical certifications from proposed subcontractors for specific time periods) he or she will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding ten thousand dollars ($10,000) which are not exempt from the provisions of the Equal Opportunity clause, and that he or she will retain such certifications in his or her files. NOTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001. Company ) r k (7svi.ST12u Own' •' By: . , J D Title: V(Ct IktA4 „in, r Date: 5/2/0 1-28 (10) DISCLOSURE OF LOBBYING ACTIVITIES • Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: D a. Contract ❑ a. Bid/offer/application ❑ a. Initial filing b. Grant b. Initial award b. Material change c. Cooperative agreement c. Post-award For Material Change Only: d. Loan Year Quarter__ e. Loan guarantee Date of last report f. Loan insurance 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No.4 is Subawardee. Enter Name ©Prime ❑Subawardee and Address of Prime: Tier_ _,if known Congressional District, if known: Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable S. Federal Action Number,if known: 9. Award Amount,if known: 10. Name and Address of Lobbying Entity b. Individuals Performing Services(including address if (If individual, last name, first name, MO: different from No. 10a) (Last name, first name, MI): 11. Information requested through this form is authorized by Title Signature: 31 U.S.C.Section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by print Name: the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C.1352. This Title: information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less Telephone No.:_, Date: than$10,000 and not more than$100,000 for each such failure. Federal Use Only: Authorized for Local Reproduction Standard Form—LLL(Rev.7-97) Standard Form LLL Rev.06-04-90 1-28 (11) INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBs,YING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient. at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to Title 31 U.S.C. section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee if the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (Item 1). If known, enter the i full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in Item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant, or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "REP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in Item 4 or 5. 10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in Item 4 to influenced the covered Federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10(a). Enter Last Name, First Name and Middle Initial(MI). 11. The certifying official shall sign and date the form, print his/her name, title, and telephone number. According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. The valid OMB control number for this information collection is OMB NO. 0348-0046. Public reporting burden for this collection of information is estimated to ' average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. 1-28 (12) CONTRACTOR'S CERTIFICATION on FEDERAL CONTRACT REQUIREMENTS PROJECT NO. D13005 LOS SERRANOS INFRASTRUCTURE— STORM DRAIN IMPROVEMENTS ON COUNTRY CLUB DRIVE I HEREBY CERTIFY THAT I HAVE REVIEWED THE DIVERSIFIED FEDERAL CONSTRUCTION CONTRACT RELATED REQUIREMENTS IMPOSED ON THE CONTRACTOR(S) OF HUD - FUNDED CONSTRUCTION PROJECTS AND I FULLY UNDERSTAND ALL MY OBLIGATIONS IF THE PROJECT IS AWARDED TO ME. • TITLE /1 Name of Contractor &inu I -c YYJunie z. CA . ' 2502 J Address Signature ✓��5►/arch+ Title 5/2. / / S Date Total Bid Amount in NUMBERS 1-28 (13) ORIGINAL BID DOCUMENTS/ RECEIVED BY ( fit e �! J DATE: T- 7- CITY - Zy- CITY OF CHINO HILLS BID SUBMITTAL/OPENING WORKSHEET PROJECT: Los Serranos Infrastructure Improvements Phase 2B BID OPENING DATE: May 28, 2015 TIME: 2:00 P.M. NO. CONTRACTOR BID AMOUNT COMMENTS w (n W fD Z U 0p CJ 0 o z w m w w o w Ind Q > FraJo &'D-f1ia3 Inc. 1 . I C$0 W.Scan 66e-rxu-do 41. 51e 6 Coona, Q4 6111 >-1 35 ‘92 . 14 ✓ tdi Cohs{ywekh, J.46- 2. (9 g0 T6,1ti) L644, 334 Soo .©0 ✓ M u vl-t - , G4 1?3t92. Lone Rk.Imo. 3. P. 0 6o/C 5+503 457 Tao.co f iRvine. 0f4 (72&,Kq - 45-62 Nb ( S\-Pc2. PIUNktcmci Une3 4. S1cco felt Styke1- 4310 149 148,0 '7 f Rita- Lorne CR- q n01 Page i of 3 — T L g10 pOCUMEN-fS Y OF GN1Np HORS HEEL 1G�NP UB OPES I 28 pRFtECE`VED gY SUBMITTAL/OPENING UgMI RAU a COMMENjs We.. g�D events Ph tune�m Prov f�astcuu M f RO. CONTIs ser`ano aInfrastructure 28, 2��5 TIME: 2:00 PB D PMOUN 0 u� w P DAIS: Ma m N 61D O9CONNN�Gt0R 0 v m U 6; r LAV •f, l/ a6 0 60)0 .. ti� Gfr gay 4 ,-3p .� C `I131(09 , 0 sus 6. q� a2 cru 111 it ek Acbg, 1512 I'll FA1 )I-ACOVA twit. fl S• o h 101.110111 ,. , X2.0154 SSC° 1' Page of i GIIdALBID DOGDI�ENTS I OF CHIN WIoRS NEET I NED DATE 6Y BIp SUBMITTAL/OPENING UBern AtUs phase 25 COMMENTS Im�rO Infrastructure M gerrau°s Intr �a p, AMOUNT y pRpJ CT' Los ATE Ma 28,2015 TIME: 2' gID AM o cn = o BIO OPENING o ° Q m NO• act' b�� co 0t�on, lncD GO 1 Caeu eGodo, Suite Cemennte, Ca 92 673 9 San Clem Sit 10. lai itirtitt 011 OF C101° HI-LS Page of